Coutinho Hannah M, Leenstra Tjalling, Acosta Luz P, Su Li, Jarilla Blanca, Jiz Mario A, Langdon Gretchen C, Olveda Remigio M, McGarvey Stephen T, Kurtis Jonathan D, Friedman Jennifer F
Center for International Health Research (CIHR), Rhode Island Hospital, Brown University Medical School, Providence, RI 02903, USA.
Am J Trop Med Hyg. 2006 Oct;75(4):720-6.
Schistosomiasis is associated with undernutrition, but the mechanisms involved remain unknown. We analyzed baseline and follow-up data from a longitudinal treatment-reinfection study in N = 477 Schistosoma japonicum-infected subjects 7-20 years of age from Leyte, the Philippines. After baseline treatment with praziquantel, follow-up visits were scheduled every 3 months for 18 months; stool, venous blood, and anthropometric measurements were collected at each visit. Cytokine production by peripheral blood mononuclear cells (PBMCs) stimulated with specific S. japonicum antigens was measured once 4 weeks after treatment. After adjustment for confounders, S. japonicum intensity was associated with decreased serum albumin and Z-scores (all P < 0.05) and with increased serum C-reactive protein (CRP) and interleukin (IL)-6. CRP was associated with decreased albumin and Z-scores (all P < 0.01). Production of IL-1b and tumor necrosis factor (TNF)-alpha in response to worm antigen was associated with decreased albumin (both P < 0.005) and height-for-age Z-score (TNF-alpha only, P = 0.05). S. japonicum-associated undernutrition may, in part, result directly from inflammation.
血吸虫病与营养不良有关，但其涉及的机制尚不清楚。我们分析了来自菲律宾莱特岛477名7至20岁日本血吸虫感染受试者的纵向治疗-再感染研究的基线和随访数据。在用吡喹酮进行基线治疗后，计划每3个月进行一次为期18个月的随访；每次随访时收集粪便、静脉血和人体测量数据。治疗4周后，测量用特定日本血吸虫抗原刺激的外周血单核细胞（PBMC）产生的细胞因子。在对混杂因素进行调整后，日本血吸虫感染强度与血清白蛋白降低和Z评分降低（所有P<0.05）以及血清C反应蛋白（CRP）和白细胞介素（IL）-6升高有关。CRP与白蛋白降低和Z评分降低有关（所有P<0.01）。对蠕虫抗原产生的IL-1β和肿瘤坏死因子（TNF）-α与白蛋白降低（两者P<0.005）和年龄别身高Z评分降低（仅TNF-α，P=0.05）有关。日本血吸虫相关的营养不良可能部分直接源于炎症。
